[The shadow of ischemia. Therapeutic window]

The mechanisms leading to irreversible ischemic damage are progressively better understood. Hopefully, these major advances will contribute to the design and clinical development of more powerful drugs aimed to combat the tremendous burden of stroke in developed countries. More sensitive neuroimaging techniques able to identify the metabolic and structural state of hypoperfused brain tissue are also available in research centres. Presumably, these techniques will be in the short future accessible to most stroke centres and this could result in the administration of stroke therapies tailored to the individual needs of patients. The review that follows tackles on some of the main advances achieved in recent years in this exciting field.